Introduction: Hypertension is a major public health problem, and it is a major risk factor for stroke. The most important pathophysiologic mechanism for the development of stroke is the induction of atherosclerosis. Carotid intima-media thickness (CIMT) is a very reliable and reproducible marker of the degree of atherosclerosis and has a good correlation with the onset/ severity of clinical manifestations. Materials and Methods: This study is an observational comparative cross-sectional type which measured the CIMT (using B-mode ultrasound) of 100 hypertensive patients with CT evidence of stroke and 100 normotensive age and sex-matched controls. The data was analyzed using SPSS version 17. Statistical tests were considered significant at p-value ≤0.05 at a confidence interval of 95%. Results: The mean age of the cases was 62.4 ± 11.8 years while that for the controls was 58.3 ± 12.5 years. The mean right and left CIMT were 1.02 ± 0.24 mm and 1.04 ± 0.32 mm respectively, with a range of 0.8 to 1.8 mm when compared to matched normotensive controls with a mean CIMT of 0.72 ± 0.15 mm and 0.76 ± 0.14 mm on the right and left respectively, and a range of 0.5 to 0.9 mm. Conclusion: This study found a consistent statistically significant increase in CIMT of hypertensive adults with stroke when compared with normotensive controls (p<0.001). In addition, CIMT values were found to increase with increasing age among the normotensives.